Swollen Ankles and Swollen Feet (cont.)

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

How are swollen ankles and swollen feet diagnosed?

Clinical observation and examination is the way swollen feet and ankles are diagnosed. A health care professional will likely ask questions about the swelling to obtain specific information and gain insight into the underlying cause of the swelling; once the cause is determined, treatments can be designed to help the patient. Simple observation and a patient's verbal description of the swollen area may be enough to presumptively diagnose the cause. For example:

a swollen ankle that the patient "twisted" a day ago is probably due a sprain;

a swollen foot that is warm with reddish skin in a person with diabetes, with a small cut on the foot is likely caused by an infection;

a bilateral foot and ankle swelling in a cardiac patient who did not take the prescribed diuretics is probably caused by a combination of dependent edema, poor fluid management and decreased cardiac function.

Laboratory tests are usually not used to diagnose feet and ankle swelling; however, they may be needed to be ordered in some patients to help diagnose underlying causes of the swelling.

What is the treatment for swollen feet and swollen ankles?

The treatment for swollen feet and ankles depends on the underlying cause(s). For many people, simply raising their feet above their heart or simply getting off their feet regularly during the day will reduce or eliminate the swelling. However, for many other people, treatment of the underlying cause of the swelling may include antibiotics for infections, a splint or wrap for a sprain, taking appropriate medications for CHF or gout.

Emergent and urgent treatment is infrequent for foot or ankle swelling itself, but does occur for certain underlying causes where feet and ankle swelling or localized swelling is an important symptom and sometimes the major symptom. Examples include: